Factors Associated with Readmission Among Individuals with One Previous Episode of Schizophrenia in Southern Thailand: A University Hospital-based Retrospective Study

Abstract

Objective: Schizophrenia is a chronic disease that has residual symptoms and relapse. The study aims to explore factors associated with readmission from symptom relapse among individuals with schizophrenia. Material and Methods: Medical records of patients who had their first schizophrenia diagnosis, in the Songklanagarind hospital’s inpatient psychiatric unit, were retrospectively reviewed for the period from January 2007 to December 2019. This yielded data outlining demographic information, profiles of schizophrenia, and treatment. Descriptive statistical analysis was utilized to process all data, and factors associated with readmission were investigated using bivariate and multivariate analyses. Results: Reviewed medical records identified a sample size of 156 individuals with schizophrenia. The majority were male (50.6%), Buddhist (85.9%), unmarried (80.1%), unemployed (50.6%), and living with their families (90.4%). Mean age was 39.2 years. From the 156 patients, they were divided into two groups; the readmission group and the non-readmission group. Readmission was defined as rehospitalization to a psychiatric unit within 5 years after their first schizophrenia diagnosis. Of all of them, 84 (53.8%) featured readmission whereas 72 (46.2%) were non-readmission. The first to fifth readmission rate was 22.4%, 12.8%, 9.6%, 5.1%, 3.8%, respectively. Multivariate analysis indicated that individuals with schizophrenia having stressful life events, non-adherence to medication, prescription changes, and lack of insight were all factors with a statistically significant association to readmission. Conclusion: Stressful life events, adverse events, non-adherence, change the prescription, and lack of insight were related to readmission. Emphasizing multimodality of treatment could be key to successful readmission prevention for individuals with schizophrenia.